4064 Mica Tr - Inspection FormCit oti'dil
Residential Sanitary Sewer Service
Compliance Inspection
Date / l ,/7 )I
Nam
t' i
PID Number
House Number 7 ), 1- Street Name
Poor Pipe joints
Mineral Deposits _.
4" to 6" Transition:
Time
1<( rr
OwnerlOccupar
Ltignature '
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Proper ty Owner
Disk #
CO Q am
Pm
Sag /Pipe Deflection
Damaged Pipe
„ „ ' •
Transition / � 7/� ?
Record Number
Alternative Mailing Address Phone
For information call 651.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks 1
Obstruction
Unable to push past
feet
Entered S L. at
Notes
i� • o.am
Time • Pm
Inspector Signature
1
/1
_ .
Length of Service: J Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral In ection Findings
Roots
Yellow Copy: City of Eagan Pink Copy: SEH
Number
Discharged
Total
Correctly
Incorrectly
Unknown
Sump pumps
Foundation drains
Roof drains
Cit oti'dil
Residential Sanitary Sewer Service
Compliance Inspection
Date / l ,/7 )I
Nam
t' i
PID Number
House Number 7 ), 1- Street Name
Poor Pipe joints
Mineral Deposits _.
4" to 6" Transition:
Time
1<( rr
OwnerlOccupar
Ltignature '
Compliance
No foundation drain connection
No roof drain connection
O Sump pit not connected to
sanitary sewer
O Sump pump properly piped
No sump pump
White Copy: Proper ty Owner
Disk #
CO Q am
Pm
Sag /Pipe Deflection
Damaged Pipe
„ „ ' •
Transition / � 7/� ?
Record Number
Alternative Mailing Address Phone
For information call 651.470.2788
Non - Compliance
O Clear water connections to
sanitary sewer
O Service lateral defects
O Defective manholes
O Sump pump connected to sanitary
sewer
O Flexible sump pump piping
Number of stacks 1
Obstruction
Unable to push past
feet
Entered S L. at
Notes
i� • o.am
Time • Pm
Inspector Signature
1
/1
_ .
Length of Service: J Final Cleanout:
No Access
O No one in
O Access to service
lateral needed
O Inspection
refused
Service Lateral In ection Findings
Roots
Yellow Copy: City of Eagan Pink Copy: SEH